Noninvasive oscillometric cardiac output determination in the intensive care unit - comparison with invasive transpulmonary thermodilution.
Noninvasive oscillometric cardiac output determination in the intensive care unit - comparison with invasive transpulmonary thermodilution.
复制标题
重症监护病房中的无创振荡心脏输出测定 - 与侵入性的转肺热稀释。
DOI：
10.1038/s41598-017-10527-3
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发表时间：
2017-08-30
影响因子：
4.6
通讯作者：
Giet MV
中科院分区：
文献类型：
--
作者：
Reshetnik A;Compton F;Schölzel A;Tölle M;Zidek W;Giet MV
心输出量(CO)的评估通常采用侵入性技术，需要在重症监护病房(ICU)使用专门的设备。利用TEL-O-GRAPH(TEL-O-GRAPHER)图，可以从测量血压的脉搏波中提取出CO。对38例血液动力学不稳定的ICU患者进行了84次对比测量，比较了TG测定的CO和每搏输出量(SV)与Picco系统(PICCO)的经肺温度稀释测定。TG显著低估了SV(33.3 ± 9.0 ml/m2 vs.44.3 ± 14.4 ml/m2，p <； 0.001)和CO(2.7min± 0.5 L/m in/m2 vs 3.8 ± 1.2 L/m in/m2，p <； 0.001)，示波臂动脉收缩压显著低于有创股动脉压，舒张压显著高于有创股动脉压。CO维度与Tg低估CO之间存在线性相关关系。在69.5%的测量中，通过液体挑战正确跟踪CO变化是可能的。振荡法无创CO在ICU中是可能的，但这种新方法的准确度和精密度还不够。在血液动力学不稳定的患者中，应用校正因子来解释随CO增加而观察到的CO低估的线性增加，可以改善用TG评估CO的效果。
Assessment of the cardiac output (CO) is usually performed with invasive techniques requiring specialized equipment in the intensive care unit (ICU). With TEL-O-GRAPH (TG), CO can be derived from the oscillometrically obtained brachial pulse wave during the measurement of brachial blood pressure. CO and stroke volume (SV) determinations with TG were compared with transpulmonary thermodilution measurements with the PICCO system (PICCO) in 38 haemodynamically unstable ICU patients with a total of 84 comparison measurements performed. SV (33.3 ± 9.0 ml/m2 vs. 44.3 ± 14.4 ml/m2, p < 0.001) and CO (2.7 ± 0.5 l/min/m2 vs. 3.8 ± 1.2 l/min/m2, p < 0.001) were underestimated significantly with TG and oscillometric brachial systolic blood pressure (BP) was significantly lower and diastolic BP significantly higher than invasive femoral artery pressure. A linear correlation was found between CO dimension and CO underestimation with TG. Correct tracking of CO changes with a fluid challenge was possible in 69.5% of measurements. Oscillometric noninvasive CO is possible in the ICU, but accuracy and precision of this new method are lacking. Implementation of a correction factor accounting for the linear increase in CO underestimation observed with increasing CO could improve CO assessment with TG in haemodynamically unstable patients.
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DOI：
10.1016/s1053-0770(98)90093-3
发表时间：
1998-10-01
影响因子：
2.8
作者：
Gust, R;Gottschalk, A;Martin, E
通讯作者：
Martin, E
影响因子：
3.6
作者：
Parra, V.;Fita, G.;Pare, C.
通讯作者：
Pare, C.
影响因子：
2.2
作者：
Prasser, Christopher;Bele, Sylvia;Wiesenack, Christoph
通讯作者：
Wiesenack, Christoph
影响因子：
9.8
作者：
Compton, F. D.;Zukunft, B.;Schaefer, J. -H.
通讯作者：
Schaefer, J. -H.
影响因子：
9.8
作者：
Biancofiore, G.;Critchley, L. A. H.;Filipponi, F.
通讯作者：
Filipponi, F.